Cancer Diagnosis: The Experience of Grief

What are the symptoms of grief?

For both the person facing death and survivors after the death of a loved one, it is natural to experience many symptoms of grief. These can include:

Physical symptoms

Emotional symptoms

Spiritual symptoms

Lack of energy; fatigue

Headaches and upset stomach

Excessive sleeping or, conversely, overworking and excessive activity

Memory lapses, distraction, and preoccupation

Irritability

Depression and, conversely, feelings of euphoria

Extreme anger or, conversely, feelings of being resigned to the situation

Feelings of being closer to God or, conversely, feelings of anger and outrage at God

Strengthening of faith or, conversely, questioning of faith

What are the different stages of grief?

Grieving is a normal response to a loss. The loss can include the loss of your normal daily routine, the impact of the diagnosis on other family members, and the financial impact of the diagnosis. The grieving process varies from person to person in terms of the order in which one deals with the stages of grief, as well as the time it takes to go through the stages of grief. The person with cancer, spouses, parents, siblings, and other family members will all experience grief. Grief is usually divided into five stages:

Denial. Denial is a stage where people try to believe that the cancer diagnosis is not happening to them or their family. One may feel numb, or in a state of shock. Denial is a protective emotion when a life event is too overwhelming to deal with all at once.

Anger. Anger is a stage in which you understand the cancer diagnosis but are very upset and angry that it has happened to you, a friend, or family member. One of the best ways of dealing with bursts of anger is to exercise or participate in another type of physical activity. Talking with family and friends, other people who have cancer, and the hospital staff may also be helpful. The person also needs to be able to express his or her anger either by verbally explaining how he or she feels or writing in a journal.

Bargaining. Questioning God, asking "Why me?" and "What did I do to deserve this?" are common questions in this stage. It is normal for the person to make bargains with themselves or God, in hopes that this will make the cancer diagnosis go away. Guilt is a primary emotion during this stage. Searching for something that you personally did, which could have contributed to the cancer, is all part of bargaining. People tell themselves or God that they promise not to do something they previously did (such as arguing with family members), or to start doing something they have not done (such as going to church regularly) in exchange for recovery.

Depression and sadness. This is a stage in which the diagnosis of cancer can no longer be denied and those involved may feel a profound sense of sadness. This is normal. It can be accompanied by physical changes such as trouble sleeping or excessive sleeping, changes in appetite, difficulty concentrating on simple daily activities, or feeling a constant fear that someone else in the family will be diagnosed with cancer. It is important to talk about depression with a health care professional, such as a social worker, or counselor, or meet with a support group to help you cope with your feelings.

Acceptance. Acceptance is a stage in which you have accepted the cancer diagnosis and are at a point where cancer has been incorporated as part of your life. You have made an adjustment to the illness. This does not mean that you will never feel other emotions, but usually families find that they are better able to manage their lives overall upon reaching this stage. Going through the grieving process is the best way to cope with a cancer diagnosis. By giving yourself and your family permission to grieve, you will be able to cope.

Discussing death

Most people need honest and accurate information regarding their illness, treatment plan, treatment options, and prognosis. People communicate their fears and concerns in many ways: crying, yelling, ignoring others, seeking information from others, and writing letters. These feelings of sadness, confusion, anger, and fear are all acceptable.

It is important to understand that each person and family is different. Given that different cultures have varying beliefs about death, there is no one single right way to discuss death. In general, an open communication style allows the dying person to express his or her fears and desires. This openness does not happen overnight. The ultimate goal in discussing death with a dying person is to optimize his or her comfort and alleviate any fears. If the person is not ready to discuss death, the most helpful step spouses, family, and caregivers can take is to wait until he or she is ready. Let the person know you are willing to talk to him or her whenever he or she is ready to do so. Forcing information will usually result in anger, distrust, and emotional distance from others. Waiting until someone is ready to handle the situation will allow for better communication.